End-stage liver disease (ESLD) is synonymous with decompensated cirrhosis, a condition in which the liver is scarred and permanently damaged. Scar tissue replaces healthy liver tissue and prevents the liver from functioning normally. Scar tissue also partly blocks the flow of blood through the liver. As cirrhosis gets worse, the liver begins to fail.
It is estimated that over 500,000 adults in the United States have cirrhosis and prevalence is increasing. According to the National Center for Health Statistics (NCHS) at the Centers for Disease Control and Prevention (CDC), chronic liver disease and cirrhosis is the 9th leading cause of death, claiming over 50,000 lives annually in the U.S.
Portal hypertension is the most common serious complication of cirrhosis. The condition occurs when scar tissue partly blocks and slows the normal flow of blood through the liver, which causes high blood pressure in the portal vein. Portal hypertension may lead to other serious, life-threatening complications of ESLD including hepatorenal syndrome with acute kidney injury (HRS-AKI) and ascites.